Provider Demographics
NPI:1316230253
Name:DEAN, HENRY CLAY V (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:CLAY
Last Name:DEAN
Suffix:V
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 26TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU SAC
Mailing Address - State:WI
Mailing Address - Zip Code:53578-2204
Mailing Address - Country:US
Mailing Address - Phone:608-643-2431
Mailing Address - Fax:608-643-0048
Practice Address - Street 1:250 26TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU SAC
Practice Address - State:WI
Practice Address - Zip Code:53578-2204
Practice Address - Country:US
Practice Address - Phone:608-643-2431
Practice Address - Fax:608-643-0048
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-9156208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery